Healthcare fraud has become a menace to most enforcement entities in the US. In an attempt to shield wasteful spending of taxpayer money, enforcement of the healthcare law has become a priority. Task forces have been set up to curb this menace. Culprits of healthcare rackets include practitioners in the medical field and owners of healthcare firms. Our feature case is “US government vs. US Occupational Healthcare Corp” (FBI par 35).
Description of the organization
“US Occupational Healthcare Corp” is a United States healthcare firm. Its main premises are located at 205 West Randolph Street, Suite 720, Chicago, and Illinois (FBI par 36). This healthcare firm performs medical examinations. The tests conducted incorporate x-rays, pulmonary processes, and electrocardiography checks. Medical entities with appropriate specialists carry out analyses on the results.
Charges filed
The US government, represented by Rick Young filed charges against “US Occupational Health”. The charges alleged that the firm had deliberately deceived Chicago City into believing that they forwarded test results to a credible medical body for analysis. Chicago city authority had fallen prey to the Healthcare firm’s deception and believed the deal was being conducted accordingly. In reality, “US Occupational health” had illegally stamped their test results with signatures obtained from credible medical entities with a relevant specialist to perform the needed analysis.
The deal to conduct detailed tests on Police and Fire department worker was awarded to US Occupational Health. Testing of employees was to begin in September 1999 and was to last for two years. The agreement only permits three one-year extensions. Despite the deal coming to an end, US Occupational Health went on performing tests on workers as if a penned-down deal existed. “US Occupational Health” received payments equal to those stipulated in the expired contract.
US Occupational Health, the accused party had a well thought out plan that led to workers mailing the outcomes of their physical tests conducted by the defendant to the employer. The results stated that relevant and qualified specialists had analyzed the outcome. The defendant had intentionally resulted in the Chicago City making an overpayment of “Six hundred thousand dollars”.US Occupational through deliberate deception made Chicago City Authority pay it a sum of money for which the city received no value. The defendant also breached an agreement with Chicago city by not fulfilling his part of the deal.
When did it occur?
The deal to conduct a detailed test on “Police and Fire departments” worker awarded to US Occupational Health was to start in September 1999. The deal was to be executed over two years and only permitted three one-year extensions. Despite the deal’s ends, US Occupational Health went on performing tests on workers up to 2005. US Occupational Health received payments equal to those stipulated in the expired contract. The health care conducted about ten thousand examinations.
Where did this occur?
“US Occupational Healthcare Corporation” is a healthcare firm in Chicago city. It won a bid to carry out various comprehensive physical tests on workers of government and private bodies in the city. The bodies included the city’s police and fire departments whose workers have to undergo vigorous medical tests to determine their fitness. The level of fitness forms the basis of allocating tasks.
The Status of the case
US Occupational Healthcare Corporation faces charges in a case where the US Government is the aggrieved party. US Occupational Healthcare Corporation is to be arraigned in court for multiple charges that include misrepresentation, healthcare rackets, etc. The case is still in its initial stages as the court proceeding is ongoing.
Parties involved
The US government, through their attorney, Rick Young, sued on behalf of Chicago city for money paid to US Occupational Healthcare Corporation in excess. US Occupational Healthcare Corporation faces charges for intentionally deceiving Chicago City that qualified specialists analyzed the test results while indeed they had not. US Occupational Healthcare Corporation was the defendant in this case for Healthcare fraud.
Conclusion
US Occupational Healthcare faces multiple charges before a Chicago judge for misrepresentation and fraud. The accused is regarded as not guilty until the case is determined by the court. Given the above case, it is evident that US Occupational Healthcare has a case to answer for intentional trickery and breach of the agreement.
Works Cited
FBI. Fourteen Defendants Charged in Eight Separate Federal Health Care Fraud Cases. FBI. 2011. Web.
The moral and functional issues of the US healthcare system have always been a hot topic for public discourse. Both independent experts and government officials sought the correct decisions. Especially this aspect of American life became relevant after the implementation of Obamacare. The purpose of this paper is to show and describe two different perspectives on the actions of US authorities due to the national healthcare policy.
State of American Healthcare Field in 2019
The analysis includes the US health care policy of the three past years and predicts the situation and problems in this sphere in 2019. According to Vogenberg (2019), “looking at 2019 and toward 2020, the shift to macro-level trends returns, reflecting market transformation during the Trump administration” (para. 1). The growing problem of resource allocation is described from the perspective of the new public agenda of a consumer society.
The results of the healthcare reform of the former president led to an increase in state budget expenditures and a conflict between the two parties. The value-based model has proved its effectiveness through thriftiness and flexibility of application. In general, there is a shift towards consumer interest, which also manifests itself in changes in the health insurance system, the introduction of mass media corporations in the health field.
The opinion of Authorities on US Healthcare Model
This appeal describes several significant mistakes in healthcare management and a list of possible changes and possible solutions. It is possible to note that “while the Administration has made much progress in reforming the American health care system, significant obstacles remain” (US Department of Health and Human Services, 2018, p. 2). The main reforms are increasing the powers of doctors, supporting the promotion of the value-based model, the abolition of market regulations, and the free choice of pricing policy among consumers. These reforms are proposed by representatives of various departments of the US government.
Conclusion
The authors of both articles mostly agree with each other. This can be seen in relation to the importance of the value-based model and priority to the consumer in healthcare. There is a general motive for the high costs and the urgent need to solve the accumulated problems created by the past reform. The voice of the American people may decide the further nature of the changes and the path of development of the US healthcare structure.
The healthcare sector has been evolving over the last few decades occasioned by changing patient needs. The involved stakeholders seek to create an environment that enables patient safety. However, errors happen due to human input in the system. When mistakes occur in the provision of care services, it may be termed as negligence, which is punishable by law. Healthcare practitioners put the patients’ safety first, and when an error occurs, the problem lies in differentiating negligence from a mistake. On the other side, a just culture requires the creation of an open and honest environment where healthcare practitioners can report different occurrences in the workplace to ensure patient safety. This paper explores the criminalization of healthcare negligence within the context of a just culture.
Criminalizing negligence
Healthcare practitioners make errors, which may cause morbidity or mortality. One of the ways to look at such cases is to identify the responsible individual and hold him or her accountable for the mistakes made (Oyebode, 2013). As such, if one is found guilty, he or she is punishable under criminal law. However, the element of criminalizing negligence points to intention, where a practitioner premeditates a given decision and the consequent action. However, this approach has many drawbacks and it may compromise the patients’ safety. For instance, assuming a nurse is supposed to obtain some blood samples for specified tests and he or she forgets. Later on, the patient undergoes a certain medical procedure, which leads to an adverse health outcome. In this case, the nurse will be in a dilemma on whether to confess that the required blood tests were not done to facilitate the right intervention procedures. However, due to the criminalization of negligence, the nurse will be liable, and he or she may face a jail term if found guilty. On the other side, the nurse may decide to withhold information that the blood tests were not carried out in a bid to avoid being culpable for the adverse health outcome.
Criminalizing negligence will encourage a practitioner to withhold information as a protective mechanism from the criminal law. However, this trend contradicts the principle of a just culture where open and honest reporting is encouraged to ensure the patients’ safety. Under this premise, the provision of care occurs within a system whereby practitioners are supposed to report any issue arising during the execution of their duties. Such reporting encourages the improvement of the system to avoid repeating the same mistakes in the future (Oyebode, 2013). Therefore, criminalizing negligence cannot occur in the same environment with a just culture. As such, the contentious issue lies in determining which approach serves the best interests of all stakeholders. On one side, healthcare practitioners should be held accountable for their decisions and actions. However, when errors occur, the element of intent, which underscores a crime, should not arise because taking such an approach will hinder the efforts being made to ensure patient safety.
Conclusion
In conclusion, punitive measures like criminalizing negligence may have short-term effects like increased caution in the execution of one’s duties. However, this approach affects patient safety in cases where a practitioner fails to communicate openly for fear of criminal repercussions associated with making mistakes. Therefore, adopting a just culture where individuals are held accountable while at the same time allowing open and honest communication offers a better alternative to criminalizing negligence.
Reference
Oyebode, F. (2013). Clinical errors and medical negligence. Medical Principles and Practice, 22, 323-333.
The paper provides the analysis of the New Jersey State legislative process and focuses on one of the bills suggested for the legislature’s consideration. The selected bill is aimed to make changes in abortion-related legislation. Specifically, the proposed regulations refer to late-term abortions with the fetus being viable. Upon reviewing the state’s legislative system, the rationale for choosing the bill is given. Further, the opinion of the researcher on the issue is explained. Considerable attention is paid to the perspective view of such important stakeholders like the American Nurses Association and the American College of Obstetricians and Gynecologists. Further, there is an analysis of the legislation’s influence on nurses and the nursing profession. Finally, a brief identification of the key people in New Jersey State’s senate and assembly is suggested. The paper discusses one of the acutest healthcare and legal issues prevailing in the USA using scholarly and evidence-based sources.
The Description of the New Jersey Legislative Process
The government of the State of New Jersey, as well as the USA’s, is composed of three branches: judicial, executive, and legislative. The principal responsibility of the former is the enactment of laws. The executive branch is accountable for the implementation of the programs initiated by the law. Finally, the judiciary branch is the one punishing those breaking the law and settling disputes (“The lawmaking process,” n.d.). The legislature of the New Jersey State consists of two Houses: an 80-member General Assembly and a 40-member Senate. The minimum age for becoming a senator is thirty, and the person also has to have resided in New Jersey for at least four years before the election. To become a General Assembly member, a candidate must be twenty-one years old minimum and the state’s resident for at least two years (“The lawmaking process,” n.d.). Additionally, the candidates must have lived in their prospective legislative district for a year preceding the election.
The legislative organization of the state presupposes the election of a presiding officer in each of the Houses. The President of the Senate and the Speaker of the General Assembly are the second and third “in line of succession to the governorship,” respectively (“The lawmaking process,” n.d., para. 5). The President and the Speaker are the ones deciding on the meeting schedules and the calendar of the bills to be reviewed. Also, these two officers refer the bills to the committee for further discussion.
The legislative process in New Jersey incorporates several phases, which the bill has to pass in order to become a law. The first stage is the development of the idea when a legislator is determined to sponsor some bill, be it at somebody’s suggestion or the governor’s idea. Next, the bill has to be drafted by the Office of Legislative Services (“The New Jersey legislative,” n.d.). The Office also arranges the bill appropriately in accordance with the technical form required. After that, the bill is given to the assembly clerk or senate secretary, who reads its title out loud. This moment is known as “the first reading” of the bill (“The New Jersey legislative,” n.d., p. 1). Upon this procedure, the bill is printed and delivered to the public.
The next phase is committee reference, which involves referring the bill to a committee for analysis. However, the assembly speaker or the Senate President may also transfer the bill to the second reading to make its consideration faster. Then, upon settling the date, the bill is reviewed by the committee at a meeting that is open to the public (“The New Jersey legislative,” n.d.). At this meeting, the committee has several options of presenting the bill: ether as it is, or with amendments, or by a “substitute bill” (“The New Jersey legislative,” n.d., p. 1). If the Senate or Assembly does not report or consider the bill, it stays in the committee.
The second time the bill is read out loud is called the second reading. This procedure takes place when the bill is referred to the floor. It is possible for the bill to be amended on the floor (“The New Jersey legislative,” n.d.). After the third reading, the Assembly or the Senate members must vote if they deem it to be returned to the second reading or to be modified. The second and third readings do not necessarily occur on the same day. This can happen only if there is an “emergency vote” of three-fourths of the members (60 votes in the Assembly and 30 in the Senate, respectively (“The New Jersey legislative,” n.d., p. 1). If the majority of the Assembly’s or the Senate’s members vote for the bill, it is transferred to the other chamber. If there is no support from the majority, the bill may be sent back to the committee.
Upon the previously described procedures, the bill has to pass them in the second House. If the second entity votes for some amends, the bill is returned to the first one so that its members could vote for suggested changes. The bill is approved after the majority of both Houses’ representatives have voted for it. Finally, the bill gets to the governor, who can either sign it or veto it conditionally or absolutely (“The New Jersey legislative,” n.d.). A bill becomes a law after the governor signs it or in 45 days if “no action is taken” (“The New Jersey legislative,” n.d., p. 1). As such, there is no difference between the state and assembly versions of the bill. If the bill is vetoed, the legislature can override the veto by two-thirds of votes. The new law gains power either on the day pointed out in its text or on July 4th following its authorization.
The Rationale for Choosing the Legislation
There is no financial statement attached to the bill, but it is still possible to discuss its merits and demerits. First of all, it is necessary to point out the benefits of the legislation for the public’s health and welfare. Should the bill be enacted, it will protect the rights of unborn children and eliminate the danger of death for women having an abortion at a late-term. However, there is also an opposite effect of the legislation on women’s health and welfare. Specifically, as Bird (2014) argues, fetal pain and fetal homicide laws, which are aimed at protecting the rights of unborn children, violate the rights of women. According to the researcher, the enactment of fetal pain laws unconstitutionally violates women’s right to “reproduce without state interference” (Bird, 2014, p. 40). Erdman (2017) states that several crucial struggles exist in relation to the abortion law, such as health-, justice-, and morality-related. The reason why this bill was selected for analysis is that the question of post-viability abortions, along with other abortion-related questions, is that there still exist many gaps in the legal consideration of the issue.
My View and Position
Personally, I consider this legislation necessary since I support childbirth over abortion. A growing number of abortions leads to considerable financial losses. However, what is probably the most crucial factor for me, abortions, especially at such a late-term, are unethical and immoral. At the prenatal age of 21 weeks, most fetuses are already viable, meaning that they have developed many systems, and killing them is immoral. Thus, I agree with the declaration made in the legislation stating that the unborn child’s viability “strongly favors appropriate delivery rather than abortion” (“Post-viability protection act,” 2018, p. 2). I support the opinion that if the mother’s health is in danger, abortion should be chosen over childbirth. However, as the proposed bill states, the longer term of pregnancy, the more risks emerge for the mother (“Post-viability protection act,” 2018). Therefore, if the bill becomes a law, it will eliminate the danger both for women and unborn children. At the same time, the suggested legislation guarantees the protection of a woman’s health and life in case of a severe and immediate medical emergency (“Post-viability protection act,” 2018). All things considered, I am in favor of the bill.
The Perspective View of Other Stakeholders
Some of the most significant healthcare stakeholders are the American Nurses Association (ANA) and the American College of Obstetricians and Gynecologists (ACOG). To find out their position, it would be enough to visit their respective websites since both of these organizations have published their opinions on the issue of abortions. According to these statements, neither ANA nor ACOG supports the suggested legislation. ANA declares that its primary duty is taking care of the patients in all aspects of their healthcare needs, including the reproductive ones (“Reproductive health,” n.d.). Also, ANA finds it necessary to entitle its patients to the right to privacy and decision-making without any restraints or pressure. The statement of ANA includes the approach to nurses’ participation in abortions based on their ethical views (“Reproductive health,” n.d.). However, ANA also mentions that if a patient’s life is under threat, the nurse is obliged to participate in any operations needed.
ACOG considers that women’s health is of utmost importance and that every abortion case should be grounded in facts and science. The association declares that politicians “should never interfere” in the relationship between a patient and a physician (“Facts are important,” n.d., para. 1). ACOG mentions that abortion after 21 weeks occurs in less than 1% of cases of all abortions in the USA, the instances in the second trimester being rarer and in the third – even less common. What is more, according to ACOG, there is no medical definition for late-term abortion, and healthcare specialists do not apply such a term.
ACOG emphasizes the probability of serious diseases that might induce a woman to decide in favor of abortion (“Facts are important,” n.d.). Thus, the organization believes that every individual case should be discussed by the physician and the woman and that politicians should not limit the women’s right to obtain the full information and choose for themselves in the event of high risk for the fetus to die shortly after birth, ACOG votes for the woman’s right to decide whether she wants to continue such a pregnancy. However, at this point, ACOG uses the attribute “nonviable” with the word “fetus” (“Facts are important,” n.d., para. 4). Still, the association argues that “in any case,” the decision should be up to the woman (“Facts are important,” n.d., para. 4). ACOG is against the politicians’ involvement in medical matters, finding it unacceptable that the law could make a physician wait until the situation becomes life-threatening for the woman to allow an abortion.
The Effect of the Legislation on Nurses and the Nursing Profession
Nurses face numerous issues while performing their professional duties, and they frequently suffer from physical and emotional burnout at work. Abortion-related care is one of the most complicated areas of nurses’ work in psychological respect. Research performed by Yang, Che, Hsieh, and Wu (2016) indicates that the problem of concealing emotions when assisting in abortions is acute among nurses. Other subtopics related to this major issue include self-protection, mental anxiety, contradictory feelings, respect for life, and the impossibility to refuse (Yang et al., 2016). Additionally, scholars have found that in many cases, nurses’ rights are neglected, and they have to assist in the operations, which they would rather avoid seeing.
Many nurses feel uncomfortable when they have to participate in abortion procedures. Research by McLemore, Kools and Levi (2015) reports that nursing specialists may experience fear, discomfort, uneasiness, and other unpleasant feelings when they assist in abortions. There are some nurses who consider abortion as childbirth anyway (McLemore et al., 2015). Still, the majority of these healthcare employees do not feel entirely comfortable when left without a choice whether to participate in such operations. Therefore, the legislation will have a positive effect on nurses’ decision-making rights.
Identifying the Key People
New Jersey’s 25th general assembly district typically has two representatives. However, currently, one of the seats is temporarily vacant due to the death of Anthony R. Bucco on September 16, 2019 (“Anthony Bucco,” n.d.). Until recently, Bucco’s son, Anthony Bucco Jr., a Republican, occupied his late father’s seat (“Anthony Bucco Jr.,” n.d.). Anthony Bucco Jr. served as a minority conference leader (“Anthony Bucco Jr.,” n.d.). Another assembly representative is Michael Carroll, also a Republican (“New Jersey general assembly district 25,” n.d.). The senator of the state is Bob Menendez, a Democrat who has been in the office since 2006 (“Bob Menendez,” n.d.).
References
Anthony Bucco. (n.d.). Web.
Anthony Bucco Jr. (n.d.). Web.
Bird, B. (2014). Fetal personhood laws as limits to maternal personhood at any stage of pregnancy: Balancing fetal and maternal interests at post-viability among fetal pain and fetal homicide laws. Hastings Women’s Law Journal, 25(1), 39-56.
McLemore, M. R., Kools, S., & Levi, A. J. (2015). Calculus formation: Nurses’ decision‐making in abortion‐related care. Research in Nursing & Health, 38(3), 222-231.
Healthcare is one of the primary concerns of all countries (at least, it is stipulated by their governments). However, developing countries have scarce resources, which leads to absolutely insufficient funding of their healthcare systems, which, in its turn, results in low quality of services provided, inaccessibility of healthcare services and so on. For instance, in India only 1% of GDP is spent on healthcare (Luthra, 2012). More so, population’s poverty is still one of the major issues and it leads to prevalence of such diseases as malnutrition, TB, and so on.
At the same time, Luthra (2012) adds that the growing Indian middle class requires specific attention in terms of chronic diseases. Public healthcare facilities are unable to provide high-quality services due to various reasons that are based on inappropriate funding and allocation of resources. International lending institutions donate significant funds, but these resources are often inadequately allocated, which makes them less effective (or even completely ineffective).
Clearly, the World Bank and the International Monetary Fund provide substantial aid to India, which is beneficial in many cases. Thus, these international organizations facilitate development of various programs concerning microfinancing. Leatherman, Saha, Metcalfe and Mavalankar (2014) state that micofinancing and health microinsurance have enabled many Indians to access the necessary healthcare services. One of the most effective types of microfinancing is loans members of the community provide to each other with no interest.
However, in many cases the IMF and World Bank hinder development of the country as the resources provided are allocated inefficiently. Hall, Ahmed and Swanson (2009) stress that the program of debt release often leads to more corruption and receiving more loans that are used inefficiently. The government claims that they will focus on development of the healthcare system but they do not provide any particular plan, only some declarations (Luthra, 2012). Therefore, it is possible to state that international institutions often contribute to the growth of corruption in the country and can sometimes bring temporal solutions that do not change the system and issues persist.
At the same time, healthy population is the key to development of any country. For instance, the benefits of healthy population become clear when considering performance of an organization. It has been acknowledged that company’s losses are often associated with employees’ illnesses (“Healthy workforce/healthy economy”, 2009).
Healthcare insurance, which is one of most valued benefits, takes up significant funds that could be re-allocated and used for development of the organization. Likewise, it is also possible to trace benefits of healthy population on a larger scale. Thus, Madslien (2013) states that many countries (especially the USA) spend enormous funds on healthcare systems and this expenditure is not very effective. This money could be spend to develop education or various social programs and so on as the money often goes to address illnesses rather than prevent them. Thus, prevention programs could lead to healthier populations and less expenditure.
It is necessary to add that in India, as in any other developing country. maternal mortality is very high and more than 500,000 women worldwide die because of pregnancy-related causes (Hall et al., 2009). Clearly, such high mortality leads to greater impoverishment of Indian families.
It is clear that healthy population is also beneficial for the country as people can contribute to its development. Admittedly, healthy people are more productive and can invest more effort into development of the society. At present, Indians are struggling with various issues and they have no access to proper healthcare, education and so on. If a person in a family gets ill, the entire family often becomes more impoverished. They are often outside the skilled labor force and the country lacks for qualified professionals who could develop the state.
Finally, healthy population is beneficial for development of the country as healthy people are more eager to take an active part in development of the state. Indians could be more cooperative with the government and communities could play a more active role, which could lead to sustainable development of India.
The Indian government is using funds provided by international lending institutions to develop its healthcare system. The Indian government also plans to increase the expenditure on healthcare up to 2.5% of GDP (Luthra, 2012). It is clear that collaboration with such organizations is beneficial as in some states (for example, Tamil Nadu) officials have managed to achieve significant results in the sphere of healthcare. Thus, in Tamil Nadu there is a program that ensures access to drugs to all people. As has been mentioned above, the loans form international lending organizations are also used for development of various programs associated with microfinancing.
In conclusion, it is possible to note that India has many problems in the sphere of healthcare as the vast majority of Indians are unable to access healthcare services. However, the government understands the importance of developing this sector of economy as healthy population can contribute to development of a strong economy. However, officials should use resources more efficiently especially when it comes to financial aid of international lending institutions.
Reference List
Hall, M.J., Ahmed, A., & Swanson, S.E. (2009). Answering the millennium call for the right to maternal health: The need to eliminate user fees. Yale Human Rights and Development Journal, 12(1), 62-119. Web.
Healthy workforce/healthy economy: The role of health, productivity, and disability management in addressing the nation’s health care crisis. (2009). JOEM, 51(1), 114-119. Web.
Leatherman, S. Saha, S., Metcalfe, M., & Mavalankar, D. (2014). Integrating microfinance and community health interventions: A narrative review of evidences from India. International Journal of Development Research, 4(3), 442-446. Web.
Luthra, S. (2012). An interview with Victoria Fan. The National Bureau of Asian Research. Web.
The healthcare law that was enacted this spring by the U.S. President Barrack Obama aimed at providing U.S citizens with medical cover. The law established universal medical services to all U.S. citizens and to be paid for by the federal government. The enactment of the law ends the need for private medical insurance in the country that will now provide supplementary medical coverage.
The government would fund the national healthcare through taxation and other funds that would replace the health insurance premiums that were initially paid by the citizens. This paper examines the application of economic concepts such as law of demand supply, equilibrium and managerial decisions on this healthcare law.
Managerial decision-making
Every organization aims at maximizing the profit made by the organization. In order to maximize profits, the organization needs to minimize costs. According to Png and Lehman, the management of an organization has a duty to formulate policies and make decisions that would lead to the achievement of the set goals (36).
Given that the business environment is dynamic, firm mangers usually rely on strategic decision making that involves making of decisions based on the strategies that would maximize the use of firm resources.
Some of the strategic decisions made by an organization include decisions on cost minimization and effective utilization of firm resources. In order to minimize costs, the management ensures that the operational processes are efficient, cheap quality inputs are utilized efficiently while creating valuable products that satisfy consumer needs.
Basing on the managerial decision-making, the federal government is similar to the management of organizations. It needs to ensure that all healthcare needs of U.S citizens are satisfied. Therefore, it sought to satisfy the healthcare needs by establishing the national healthcare act that would be funded through taxation. This decision to enact the act is optimal because the federal government would establish a healthy nation that would contribute to economic growth positively through increased production.
Demand, supply and market equilibrium
According to Png and Lehman, both buyers and sellers meet in a market in which there is the exchange of goods and services (121). Economic resources are usually in short supply while the needs that are to be fulfilled using the resources are usually indefinite. In addition, different people and regions are bestowed with different resources that satisfy different human needs.
Due to different endowment of resources to countries and regions, some countries have a comparative advantage in the production of a given good or service over others. In addition, the differences in resources endowment have made countries and individuals within the country to be dependent on external economies hence; they would always demand the supply of given goods and services for the fulfillment of their needs.
The law of demand posits that the demands for goods and services shrink as the prices of the goods/services increases while other things are held steady. Demand is provided in terms of quantity of the goods. The quantities of goods that are demanded by clients differ from one individual to another basing on various factors that affect demand.
Fluctuations in the quantity of a given good/service that is required by consumers fluctuates over time based various factors such as the level of proceeds for consumers, the price of the good and availability of substitutes among other factors.
The supply of goods and services occurs in the market too. Suppliers provide goods based on the quantity of the goods that consumers require in order to meet their needs. The quantity of goods/services supplied is a function of many factors including the price of the good/service, level of income for consumers, productivity and the amount of goods/services that consumers need in order to meet their needs.
The law of supply postulates that the supply of a given good/service declines as the price of the good/service decreases and vice versa with other factors being held steady (Png and Lehman 357).
Equilibrium in the market is obtained at the level in which the total of goods/services demanded by clients equates the level of goods/services supplied by different sellers in the same market.
At equilibrium, the price at which the sellers sell their products to customers is referred to as the equilibrium price while the equilibrium quantity is the quantity supplied by sellers and bought by clients in the market. At equilibrium, there is no incentive for the suppliers to increase the goods supplied because the price and income remains the same in the short term.
Similarly, customers have no incentive to increase the amount of goods demanded in the short term. The changes in other factors in the business environment can cause the amount of goods/services supplied and demanded in the market to change. Some of the factors include changes in demographics, income and productivity among other factors (Png and Lehman 123).
The economic concepts of demand and supply could also be applied to the healthcare act. The customers in include all U.S. citizens that needs medical care. The supplier is the government. The level of demand would increase if the U.S. population increased or the levels of epidemic or accidents in the country increased. The equilibrium in the provision healthcare services to the citizens would be achieved whenever the supplied services would be equal to the demanded services.
Optimization techniques
According to Png and Lehman, an optimizing firm should keep producing as long as the marginal costs incurred during production are less than the marginal revenue (183). During the production period, the company should always focus on minimizing processing costs to ensure that it meets its profit maximization objective. An organization should produce until the level in which the magical costs realized in the course of production are equal to the marginal revenue.
This is the optimal position of the firm. Any increase in production would result in losses. The management of an organization can alter this position if long-term production capacity is created. This can only happen in new management tools such as investment in new technologies and expansion of production space and plant.
The application of optimal techniques to the healthcare law would mean that the federal government should increase the provision of healthcare services as long as the marginal costs incurred in healthcare service provision is less than the marginal tax collected by the government.
The optimal level of healthcare service provision would be when the marginal cost of the services is equal to the marginal tax collected. New decisions to use advanced technology and increase healthcare services provision capacity should sought once the government increases service provision at the expense of healthcare costs.
Consumer behavior and rational choice
Organizations are involved in the production of goods and services while consumers are mainly to make consumption decisions for the produced goods. The theory of demand postulates that consumers demand goods (services) in order to meet their unlimited wants. After the goods/services are provided, the consumers consume them for satisfaction that is measured in terms of utility.
Consumers are rational in their consumption decisions because they always choose the best basket of supplied goods that would best meet their needs given the prevailing circumstances. They therefore decide the quantity of goods to purchase and the amount of money to spend on the goods. Given the rationality of consumers, the healthcare service consumers in the U.S., the U.S citizens are rational consumers too.
They would make decisions on the type of healthcare services demanded. However, the amount of money to spend on the services would not be made by the citizens, but by the federal government through taxation.
Demand functions
Demand functions indicate the existing relationship between the levels of the good demanded and the determinants of the levels demanded by the customer. The quantity of a given good demanded by consumers is determined by various factors such as the price of the good, the level of income, the prices of other related goods such as compliments and substitutes and tastes and preferences. Given these factors, the demand function of a given good can be expressed as indicated below.
D=f(P,I,PXPYT) where D- quantity demanded, P- price of the good demanded, I- Income, PX– price of related good x, PY– Price related good y and T- tastes and preferences.
Application of demand functions in the healthcare law
The demand function could also be applied to the healthcare law and the demand of healthcare in the U.S. The U.S. citizens are the consumers of healthcare services provided by the federal government under the healthcare law.
The demand of healthcare services in the U.S is determined by various factors such as exposure to risk factors, levels of income, price of healthcare among other factor. The healthcare demand function can be expressed as below.
H=f(R,I,P, O) where H- healthcare quantity demanded, R-exposure to risk factors, I-levels of Income, P-charge son the healthcare and O-other factors
An increase in any of the causative factors could alter the level of healthcare services demanded by the U.S. citizens. For instance, an increase in the number of people exposed to risky environments that could affect negatively their health could increase the demand of healthcare services. An increase in healthcare taxation could reduce the demand for healthcare services because many people would opt for private services. This is similar to an increase in income for U.S citizens.
Production theory
Production of goods and services entails utilization of various resource inputs such as labor, power, and raw materials among other factors. The theory of production involves the determination of the levels of input factors to be used by an organization to produce a given level of out.
An organization would combine different levels of factors of inputs such as labor and capital to produce a given output. However, in the course of productivity, organizations aim at minimizing the costs incurred while ensuring that the profit realized are maximum. A firm can experience increasing returns to scale if the marginal costs incurred reduce as the produced output increases.
Constant returns to scale are experienced whenever the marginal cost realized by the organization is constant as the output produced increases. On the contrary, decreasing returns to scale would be realized if the marginal costs of an organization incurred during productivity would increase as output increases.
Therefore, it is advisable that the management of the organization should produce up to that level in which the marginal cost equals the marginal revenue in order to avoid reduction in scale of returns that could lead to an exit from the market (Png and Lehman 319).
The application of the theory of production to the healthcare law implies that the government provides healthcare services using capital and labor. Capital used in the productivity of the services includes the buildings, latest technological equipment in public hospital vehicles among other capital tools.
Labor on the other hand includes all healthcare professionals employed by the state to provide quality healthcare to U.S. nationals. The cost incurred in the provision of healthcare services includes the cost of capital and labor while the revenue is obtained from healthcare taxation. Increasing returns would be realized whenever the marginal cost of providing healthcare services decreases as service provision increases.
On the contrary, the federal government would realize reducing returns to scale whenever the marginal costs incurred by the state in providing healthcare services increases as provision of healthcare services increases. The optimal healthcare service output would be at the position in which the level of marginal cost of healthcare service provision equals marginal revenue from taxes (Png and Lehman 170).
The federal government in the healthcare sector in the long run should pursue technological change and industrial revolution. This would enable the federal government increase and improve the provision of healthcare services to U.S. citizens. However, the federal government can pursue technological change if it realizes that it is providing healthcare services under decreasing returns to scale. This change of strategy would ensure that the government minimizes costs while maximizing healthcare tax revenue.
Work Cited
Png, Ivan and Lehman, Dale. Managerial Economic. New York: Willey-BlackWell. 2007.
Healthcare institutions are important components of the society, and so are healthcare practitioners. The success of any nation greatly depends on the health status of its people. Countries that have a history of disease prevalence register slow economic growth and the vice versa is true. The health industry via healthcare facilities and its practitioners facilitates the health status of a nation. For this reason, healthcare organizations are vital to the social, economic, and political stability of a nation. In most nations, major healthcare organizations are non-profitable organizations funded by the government and other non-governmental institutions. Governments unite through treaties and international goals like the Millennium goals to improve the general status of health around the world (Cooper, 2013).
The management of healthcare facilities by the government, however, makes it harder for health institutions to achieve the expected targets. As such, governments allow the private practice within the health industry to operate within certain boundaries. The private practice helps reach a larger group of people, hence improved health. Competition within the health industry, especially among hospitals and private practitioners is a healthy business approach because it helps in regulating the industry (U.S justice department & FTC, 2009). However, business executives within the industry have come up with a way to join forces and kill the competition, thus making the cost of the health acquisition rather high. The Federal Trade Commission (FTC) helps regulate such activities that compromise the quality of health and cost of acquiring health care services in the United States of America.
FTC prevents hospitals and practitioners from forming treaties and agreements that limit the competitiveness of the industry. The action of a physician-hospital organization in the United States to try to negotiate terms with third parties for its members is an illegal act in the FTC manifesto. The purpose of forming the treaty was to allow the hospitals and healthcare personnel operating alone a better way to negotiate their prices for their personal interest (Cooper, 2013). The arrangement did not consider the impacts of such activities to patients who are their daily consumers nor did it consider the third parties within the industry. The refusal of the hospitals and the health care personnel to negotiate terms with third party payers is a per Se illegal act according to the FTC (Cooper, 2013). The ability of individual organizations to negotiate differently ensures that there are enough options within the industry for all people. Increasing the cost of care is detrimental because it limits access to care, especially to the people living in poverty. Additionally, it makes it hard for the third parties to serve the society effectively because they cannot negotiate with healthcare institutions on behalf of the society.
On the other hand, the actions of the individual hospitals and the umbrella organization violated the antitrust principles of the FTC. The sole reason for merging should be to improve the effectiveness of the operation and enhance economic growth for the greater good rather than personal gain. As such, the actions of the individual hospital are illegal because they do not enhance trust and openness within the industry. The governments of the world focus on making sure that all people get medical, and health insurance covers for a better society. The failure of the hospitals to negotiate terms with the third party limits the success of the government efforts (Creighton, 2004).
Excessive competition can be detrimental to the success of the industry as well. Therefore, the creation of treaties that limit the competition can work for the betterment of the industry if the practitioners and hospitals apply certain principles. The organizations within the umbrella body could have negotiated a single bundle together, then use individual initiative to contract with the third parties. Such an approach can lift the illegal claim of the Commission (Creighton, 2004). The FTC would then have considered the union as an institution working to promote the well-being of the society while improving the revenues of the industry. Fee splitting and corporate practice of medicine are general principles that institutions within the health industry employ to achieve collective decision.
FTC uses various techniques to determine the illegality or legality of an act. The per se rule allows the Commission to rule out the possibility of a good result from a certain act. For instance, any activity that involves anti-consumer practices or violates the fundamental antitrust principles becomes automatically illegal per se regardless of the intentions and the results of the actions. To achieve the per se rule, the FTC analysis ignores the examination an action as a non-competitive behavior, thus ruling it illegal without any evidence (Cooper, 2013). In dealing with health care institutions, the commission often employs the per se rule because most of these cases do not have a legal basis. However, in case the per se rule cannot hold, the FTC chooses to settle the matter through limiting the operations of the treaty to keep it within the borders of the law. The use of the per se rule allows the Commission enough flexibility to choose the right action against the accused organization or person (U.S justice department & FTC, 2009).
References
Cooper, J. (2013). The regulatory revolution at the FTC: a thirty-year perspective on competition and consumer protection. Oxford: Oxford University Press.
U.S department of justice and the Federal trade commission. (2009). Statement of antitrust enforcement policy in healthcare: Statement of Department of Justice And Federal Trade Commission Enforcement Policy On Multi-Provider Networks. (Statement 9). Department of Justice.
Creighton, S. (2004). Diagnosing Physicians-Hospital Organizations. Remarks Before The American Health Lawyers Association, Program On Legal Issues Affecting Medical Centers And Other Teaching Institutions. Washington D.C: FTC publishers.
Americans have often criticized policies introduced by the Congress arguing that they are inefficient or even inadequate. It is possible to evaluate a healthcare policy to understand whether it can be improved or not. One of the most problematic issues is concerned with funding. Thus, the attempt by Congress to stop federal funding to the Planned Parenthood Federation of America (PPFA) has created a national debate regarding whether the taxpayer should finance an organization that procures abortions, or not (Ross, 2015). Through an objective analysis of the proposed healthcare policy, this paper shows that the bill undermines women’s rights to gain access to healthcare services and slows down America’s quest to provide universal healthcare coverage.
Policy Problem Description
Since President Richard Nixon signed the Family Planning Services and Population Research Act in 1970, millions of women in America have gained access to family planning health services through PPFA (Ness, 2015). However, since the organization started its operations, there has been an increase of abortion services at PPFA (Ness, 2015). This development has caused some legislators to question whether it is right for the federal government to continue funding the organization because it is unlawful for the government to finance abortion services (Ross, 2015).
Background Information
Social Factors Underlying the Issue
The legality of abortion, as a reproductive health service, is a divisive issue in America because of the debate between pro-life and pro-choice supporters (Farrell, 2010). The stakeholders involved in this discussion are Congress, pro-life advocates, pro-choice supporters, and women (SBA, 2015). The proposed bill affects them in different ways. For example, women would have to spend more money to seek reproductive health services if the proposed bill becomes law. Congress has a stake in this debate because it has the power to pass such a law. Pro-life and pro-choice supporters of abortion create the political pressure to influence such a change (Ziegler, 2015).
If the bill becomes law, pro-life supporters will make progress in the anti-abortion campaign. Conversely, if it fails, supporters of abortion will make progress by increasing support for abortion. If the proposed bill becomes law, it will affect more than 2.7 million people who seek reproductive health services from PPFA and its affiliates. It is noteworthy that PPFA performs one out of four abortions procured in America (Firozi, 2015). In fact, since its start, the organization has carried out more than 6 million abortions. In 2013 alone, the group performed more than 357,000 abortions (Ness, 2015).
Economic Factors Underlying the Issue
Women are the primary victims of the proposed PPFA bill. The bill aims to save the American taxpayer $528 million, which PPFA receives from the government through Medicaid reimbursements (Ness, 2015). The total government funding to PPFA is 60% of the organization’s revenue while other sources of income are private contributions, revenue from non-governmental health services, and “other” funding sources (Ness, 2015).
According to the Congressional Budget office, cutting federal funds to PPFA would increase the cost of reproductive health services by $130 million (Firozi, 2015). This figure contradicts the views of proponents of the bill who argue that funding of PPFA would decrease public spending towards reproductive health.
Ethical Factors Underlying the Issue
Informed consent is a moral issue underlying the acceptance or rejection of the proposed healthcare bill. Some people have accused Planned Parenthood of selling fetal tissue for purposes of medical research without the mother’s consent (Kaczor, 2014). This issue questions whether it is ethical for the public to continue financing the activities of PPFA or not.
Another ethical issue concerning the PPFA defunding bill concerns whether it is a moral right to terminate pregnancies before normal childbirth or not (Steffen, 2012). This debate stems from perceptual differences regarding when life starts: at conception or birth. While some people believe that abortion is like killing a human being, others believe there are particular circumstances when abortion is legal (Torre, 2015).
Political and Legal Factors Underlying the Issue
Pressure from pro-life groups has prompted six states to propose legislators to defund Planned Parenthood (Randall, 2015). Many of these cases have resulted in protracted legal debates that have often overturned the decision to defund PPFA (Ness, 2015). The main reason for the refusal to enact such laws is a conflict between federal and state laws.
However, in some states, legislators have successfully pushed for the enactment of such legislations. For example, Louisiana successfully changed its contract with Planned Parenthood, thereby offering no public funding to the organization (Randall, 2015). Such enactments have often led to increased cases of unplanned pregnancies as well as increased incidences of sexually transmitted diseases (STDs) and sexually transmitted infections (STIs).
People who have supported the defunding campaign cite PPFA’s failure to follow federal or state laws when undertaking their activities. Undercover videos that showed evidence of child abuse and sexual abuse highlight this fact. However, proponents of PPFA funding say the organization gives women more power to control their reproductive health (Ness, 2015). There is no bipartisan support in this debate. The political aspect of this impasse is the uncertainty regarding whether it is right to use public funds to finance abortion services or not. Its legal component is the possible contradiction between women’s rights and moral reasoning.
Issue Statement
Should the federal government fund an organization that offers abortion services?
Stakeholders
The primary stakeholders of the defunding debate include legislators (Congress), women, pro-life supporters, pro-choice supporters and women’s right groups. Although Congress has a divided opinion about the debate, gender groups oppose the proposal to defund PPFA because they believe it undermines women’s rights (Ziegler, 2015). Comparatively, pro-life supporters support the bill because it advances their anti-abortion campaign.
Policy Option/Alternative
In July 2015, Rand Paul (a junior Senator from Kentucky) introduced a bill to stop funding PPFA and its affiliates (Randall, 2015). The bill’s number is S.1861, and it seeks to prevent the misuse of fetal tissue and other unethical acts undertaken by PPFA by cutting federal funding to the organization (Randall, 2015). However, it does not explain how this action would affect millions of women who depend on the organization for accessing reproductive health services.
Evaluation of the Bill
Planned Parenting Defunding Act
Number S. 1826
Evaluation Criteria
Pro
Con
Effective
Defunding of PPFA would decrease the number of incidents involving the sale of fetal tissue (Torre, 2015)
Defunding of PPFA would decrease cases of sex abuse and molestation (Torre, 2015)
Defunding of PPFA would minimize loopholes where government funds are used to finance abortion services (SBA, 2015)
Defunding of PPFA would increase the cost of reproductive health services in the long run (Kaczor, 2014)
There would be an unexpected increase in Medicaid costs for unplanned pregnancies (Firozi, 2015)
Defunding of PPFA would undercut future savings that could accrue from avoiding unplanned pregnancies (Kaczor, 2014)
Efficient
Defunding of PPFA stops the rampant abortion (Steffen, 2012)
Government can relocate the funds allocated to planned parenthood to other organizations that are not plagued by scandal (SBA, 2015)
Defunding of PPFA increases funding for Medicaid through expanded coverage for family planning services (Torre, 2015)
Defunding of PPFA does not only reduce funding for abortion services but also minimizes the resources needed to provide other vital reproductive health services, such as cancer screening (Ness, 2015)
Defunding of PPFA would mean increase in reproductive health costs as women would have to pay for these services out-of-pocket (Ziegler, 2015)
Defunding of Planned Parenthood would cause unnecessary strain on other facilities that offer reproductive health services (Ness, 2015)
Equitable
PPFA would not enjoy the monopoly of providing sexual health services (SBA, 2015)
Defunding of PPFA would decrease the access of family planning services to women (Ross, 2015)
Defunding of PPFA reduces women’s control over their reproductive health (Ness, 2015)
Defunding of PPFA would slow America’s quest to overhaul its healthcare system to provide universal healthcare coverage (Firozi, 2015).
Results of the Analysis/Summary
This paper has already shown that many proponents of the PPFA defunding bill argue that funding of PPFA is similar to funding abortion (Randall, 2015). However, to comprehend this issue, it is important to understand the bill’s effectiveness, efficiency, and equity. Regarding its efficiency, the bill fails to consider the contribution made by PPFA in improving sexual health outcomes of women in America. It adopts a particular understanding of the role of PPFA by assuming that it only performs abortion services.
However, abortion is not the only service provided by PPFA. The organization also provides other services, such as cancer screening, contraceptive use, and HIV testing (among other services). Therefore, defunding of the organization would mean defunding of other essential reproductive health services. Its focus on abortion means that the bill is inefficient. The defunding bill is also ineffective because it would decrease the uptake of reproductive health services at PPFA facilities and cause unnecessary strain in other facilities that possibly lack the capacity to treat large numbers of patients.
In terms of health equity, the defunding bill limits access to healthcare services, thereby promoting inequity in the healthcare sector. The defunding bill also fails to promote the political and social development of women in the USA because it not only makes healthcare more expensive for low-income women, but it also undermines the progress made by gender activists in helping girls to take control of their sexual health. Its potential to increase cases of unplanned pregnancies would also cause social upheaval in low-income American families because parents would have less power in the planning of their families.
In this regard, there is no ethical justification for supporting the bill because it deprives low-income families of the power to take control of their sexual health. Based on these issues, my support for the defunding bill would only increase if it selectively defunds abortion services as opposed to cutting funding for all health services provided by PPFA.
Talking Points
Bill: Planned Parenting Defunding Act
Bill Number: S.1826
Description of the Bill: The Planned Parenthood defunding bill seeks to stop the misuse of fetal tissue, sexual abuse and other unethical acts undertaken by PPFA by cutting federal funding to the organization.
Problem/Issue: Is it right for the public to continue funding Planned Parenthood considering it is the largest center for procuring abortions in the USA?
Number of People Affected by the Bill: PPFA serves more than 2.7 million women.
Impact of the Problem
The total government funding to PPFA is 60% of its revenue.
Cutting federal funds to PPFA would increase the cost of public spending to reproductive health services by $130 million.
The defunding bill also fails to promote the political, social and political development of women in America because it not only makes healthcare more expensive for low-income women but also undermines the progress made by women rights activists in helping women to take control over their sexual health.
Estimated Impact of the Bill
Defunding the PPFA is an assault on women’s rights in America. Furthermore, the bill would only increase the health disparities that have already undermined progress in the health sector because fewer women (especially from low-income families) would be in a position to seek reproductive health services.
My support for the bill would only increase if it selectively defunds abortion services, as opposed to cutting funding to all activities undertaken by PPFA.
Defunding of Planned Parenthood undermines women’s rights to access healthcare and undermines America’s quest to provide universal health coverage to all people.
Conclusion
This paper has shown merits and demerits of the defunding bill. Nonetheless, an independent analysis of the facts shown in this paper reveals that defunding of PPFA is an assault on women’s rights in the US. Furthermore, the bill would only increase health disparities that have already undermined progress in the health sector because fewer women (especially from low-income families) would not be in a position to seek reproductive health services. Although other healthcare options exist, the bill minimizes the access to reproductive health services for low-income women. In this regard, the bill does not have much value.
References
Farrell, C. (2010). Abortion debate. New York, NY: ABDO Publishing Company.
Theresa Marie Schiavo had been in a vegetative state for 15 years undergoing artificial hydration and nutrition which were then stopped causing her death. Her death was the culmination of a long and hard-fought battle between her parents and her husband regarding whether she should remain in a vegetative state on life support machines or whether to let her die.
Her demise caused a dispute between not only her husband and her parents but assumed national proportions as it even pitted the state Governor against judges as well as other interested parties against each other as it went on to become one of the most significant end-of-life cases in the United States (Cerminara & Goodman, 2013).
This essay looks at the case of Terri Schiavo and the ethical issues that arose from it, the definitions used to judge cases similar to it from a bioethics perspective and it will attempt to determine which of the two opposing parties was more ethically correct in its stance.
Theresa Marie’s ordeal began on February 25, 1990 when, after suffering a heart attack caused by an imbalance of potassium in the body, she got brain damage due to insufficient oxygen in the brain. She was admitted at the Humana Northside Hospital where she was given (PEG) percutaneous endoscopic gastrostomy for hydration and nutrition purposes. She was later transferred to the College Park Rehabilitation Center, a skilled healthcare facility (Cerminara & Goodman, 2013).
After a series of transfers to various medical and rehabilitation institutions where she received care and some experimental treatment, her husband Michael Schiavo was confirmed as her legal guardian by the court.
She was then awarded a $250,000 out of court settlement for malpractice by one of her physicians. In another malpractice case she was awarded more than a million dollars by the jury whereby $750,000 was put in a trust fund for her medical care and $300,000 was awarded to her husband Michael Schiavo (Cerminara & Goodman, 2013).
Michael later had a falling out with his in-laws, the Schindlers, over his wife’s therapy where he accused them of demanding a share of the malpractice money. After this falling out, the Schindlers moved to court in an attempt to nullify the guardianship of Michael to their daughter which the court dismissed (Cerminara & Goodman, 2013).
Terri was described by physicians as being in a persistent vegetative state meaning that although she appeared to have a normal level of awareness and some attentiveness and she also slept normally, she had no content of consciousness. In the words of a few hardliners, she existed but did not live. She could not experience emotion, could not think, interact with her environment and she had no memory. Some would argue that the fact, that she did not show any physical sign of distress, did not mean that she was not suffering and as such could not be used as an excuse to terminate her life.
What is being alive? Is life merely defined by locomotion of a person and by their ability to interact with their environment and those surrounding them, the perception and/or reciprocation of emotion, the perception of pleasure and pain and the ability to react to such? A person in Terri’s condition may feel all that is around them but may lack the ability to express it.
All of Terri’s bodily functions continued despite her condition so by all definitions she was alive and she would only reach an end stage/terminal scenario when the hydration and nutrition were removed. She might have lived to a ripe old age had the nutrition and hydration continued. The removal of hydration and nutrition for Terri was tantamount to euthanasia which is ethically deplorable and medically unwarranted (Koch, 2005).
The proponents of the cessation of hydration and nutrition for Terri chiefly her husband Michael were highly unethical. It was Michael’s duty as Terri’s guardian to care for her which by all accounts he did until he sought the termination of his wife’s life support. His decision is unethical because the termination of life support is forbidden in most situations.
Furthermore the second guardian to Terri “Richard Pearse” reported that Michael’s move to terminate life support for his wife might have been influenced by the potential inheritance he stood to gain if his wife were to die (Cerminara & Goodman, 2013).
There are those who challenge the prognosis of persistent vegetative state as being doubtful, inconclusive. Their argument gains credence from some clinical studies published in the recent past, some of which state that the vegetative state cannot be definitively characterized by a total failure of cortical function. Others have found that some 12 to 34 percent of patients claimed to be persistently vegetative maintain minimal consciousness and may respond to treatment (Koch, 2005).
Conclusion
With the realization that patients in a persistent vegetative state are conscious even minimally, the argument about quality of life flies out the window as even small gestures go a long way in improving the quality of life.
Terri may not have been able to converse with her loved ones, may not have enjoyed food and drink as she used to but may have been able to appreciate simple gestures from those she loved such as smiles, soothing words and their presence. Hence it was not up to others to define her quality of life or lack thereof and decide the limits of her existence.
References
Cerminara, K., & Goodman, K. (2009). Key Events in the Case of Theresa Marie Schiavo. Web.
Koch, T. (2005). The challenge of Terri Schiavo: lessons for bioethics. Journal of Medical Ethics, 31(7), 376-378.
Intersectoral collaboration has always been one of the most crucial yet overlooked aspects of public healthcare and medical practice as a whole, including both preventive care and response to emergency situations. However, over the past years, the notion of legal cooperation between various public institutions for the sake of national safety has become quite relevant in the context of healthcare. According to the researchers, as far as healthcare is concerned, some of the major responsibilities dealing with such issues as supply distribution and epidemic dissemination control have nothing to do with the medical practice itself, placing major emphasis on the governmental and private sectors (Damari, Rostamigooran, & Farshad, 2019).
Thus, one of the most beneficial ways to reach the desired pattern of professional communication is to secure legal collaboration between the sectors in terms of prompt responses to the emergency situation. A prime example of such a legal document is a Memorandum of Understanding (MOU), standing for a formal agreement the establishes the patterns of further partnership for the stakeholders (ASTHO, 2018). In terms of the following paper, the peculiarities of MOU cooperation will be analyzed on both federal and state levels in order to define some of the fundamental features of such an agreement type.
To begin with, it is necessary to outline the primary purpose of the MOU agreement for both the health agencies and pharmacies in order to define whether the procedure itself has any benefit for the parties. Hence, one of the major benefits for healthcare institutions is the ability to secure a prompt response to emergency situations that requires a considerable supply of medications, e.g., rapid demand in vaccination during the pandemic outbreak (Balick, 2017). As far as pharmacies engaged are concerned, the MOU agreement provides them with measurable prospects on the scope of supply manufacturing and allocation of resources.
Hence, the relevance of the MOU could be examined from both perspectives, primarily benefiting the community, for the sake of which the cooperation is commenced in the first place. However, the model works only in cases when the requirements for the MPU from all the stakeholders and tangible and correlate with the real scope of the potential emergency (Fitzgerald et al., 2016). Otherwise, the cooperation will be regarded as inefficient and meaningless. For this reason, prior to developing an extensive collaboration plan, it is of paramount importance to dwell upon the overall capabilities of the pharmaceutical units willing to cooperate in order to create realistic goals for demand satisfaction in case of emergency.
In order to obtain a deeper understanding of the notion of MOU in the national context, it is necessary to outline an example of how the system works in real-life situations. The modern environment, which explicitly concerns the necessity of immediate pharmacy support, is centered around the outbreak of the global pandemic of the COVID-19 virus, causing a considerable demand for an immediate pharmacy intervention and medical supply required to address the emergency. Hence, the Centers for Disease Control and Prevention (CDC) (2020) commenced a procedure of establishing a long-term partnership with various healthcare-related facilities in order to respond to the ongoing healthcare disaster. According to the terms introduced, the CDC is willing to cooperate with pharmacy institutions among the aforementioned facilities in terms of the supply of the vaccine in case one is invented and approved by the FDA. Moreover, the jurisdiction that controls the MOU agreement proclaims the CDC as a major distributor of the vaccine and medical supplies across the state once they are provided by the pharmacies (CDC, 2020). Hence, such an example of MOU ratification, by all means, obtains a nationwide significance regardless of the state peculiarities set out by local governments.
In general, the protocols for the MOU agreements across the US are designed to respond to all types of hazardous situations that might take place within the area (Schwerzmann et al., 2017). However, according to the well-known Tenth Amendment to the US Constitution, state authorities are entitled to have a high level of autonomy when it comes to the decision-making processes relevant to the community. Thus, some states, instead of following the nationwide recommendations in terms of defining the MOU requirements, develop strategies that seem to be working for the local residents. For example, the state of Virginia has defined four major healthcare hazards that presuppose the MOU agreement formed between the healthcare agencies and pharmacies, including:
Pandemic influenza vaccine emergency response;
Antiviral emergency response;
Anthrax emergency response;
Response to a natural disaster (ASTHO, 2018, p. 4).
Hence, taking everything into consideration, it might be concluded that the MOU agreement management within the US healthcare context has now become one of the most widespread yet challenging aspects of public health and emergency response. Thus, in order to realize the level of responsibility taken, it is of crucial importance to dwell upon the detailed planning of the requirements expected as a result of the cooperation. The future implications of the MOU agreement handling should concern the peculiarities of more health hazards across local authorities.
References
ASTHO. (2018). Memorandum of agreement between Virginia department of health and _ n Virginia for emergency medical countermeasures. Web.
ASTHO. (2018). Memorandum of understanding toolkit for public health agencies and pharmacies. Web.
Balick, R. (2017). Pharmacy–public health coordination keeps communities a step ahead of pandemic influenza. Pharmacy Today, 23(8), 46.
CDC. (2020). COVID-19 vaccination program interim playbook for jurisdiction operations. Web.
CDC. (2020). Different COVID-19 vaccines. Web.
Damari, B., Rostamigooran, N., & Farshad, A. A. (2019). Challenges of memorandum of understanding as a tool for strengthening intersectoral collaboration in health system. SDH, 5(3), 170-176.
Fitzgerald, T. J., Kang, Y., Bridges, C. B., Talbert, T., Vagi, S. J., Lamont, B., & Graitcer, S. B. (2016). Integrating pharmacies into public health program planning for pandemic influenza vaccine response. Vaccine, 34(46), 5643-5648.
Schwerzmann, J., Graitcer, S. B., Jester, B., Krahl, D., Jernigan, D., Bridges, C. B., & Miller, J. (2017). Evaluating the impact of pharmacies on pandemic influenza vaccine administration. Disaster Medicine and Public Health Preparedness, 11(5), 587-593.